NPIMap

Organization Active NPI

Northwest Spine and Pain Medicine, PLLC

Doing business as Northwest Spine and Pain Medicine

  • Multi-Specialty Clinic/Center
  • Spokane, WA
National Provider Identifier
1669789228
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
NORTHWEST SPINE AND PAIN MEDICINE, PLLC
Doing business as
Northwest Spine and Pain Medicine
Practice address
3124 S Regal St
Spokane, WA 99223-4704
Phone
(509) 464-6208
Fax
(888) 316-1928
NPI assigned
Sep 2, 2010
Last updated
Aug 26, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jamie Lee Lewis, MDNPI 1073724290
Title
Ceo
Phone
(509) 464-6208

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

3124 S Regal St
Spokane, WA 99223-4704

Mailing address

PO Box 112
Spokane, WA 99210-0112
Phone (509) 464-6208

Other names 1

  • Northwest Spine and Pain Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101209001132 WA Part B Supplier - Clinic/Group Practice 5799972212 Receives reassigned benefits from 26 practitioners
Practice locations: Spokane, WA
O20240923000647 ID Part B Supplier - Clinic/Group Practice 5799972212 Receives reassigned benefits from 3 practitioners
Practice locations: Coeur D Alene, ID

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2092238Northwest Spine and Pain Medicine, PLLC3124 S Regal St, Spokane, WA 99223ComplianceApr 4, 2028
50D2163931Northwest Spine and Pain Medicine3124 S Regal St, Spokane, WA 99223Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

509 W Hanley Ave
Coeur D Alene, ID 83815
Phone (208) 667-5447

509 W Hanley Ave
Ste 10183815
Coeur D Alene, ID 83815

105 W 8th Ave
Ste 250
Spokane, WA 99204
Phone (509) 464-6208

10511 W Aero Rd
Ste 1
Spokane, WA 99224
Phone (509) 413-2140

2607 S Southeast Blvd
Bldg A
Spokane, WA 99223
Phone (509) 464-6208

5901 N Lidgerwood St
Spokane, WA 99208
Phone (509) 464-0542

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566777600000",
    "number": "1669789228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 112",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992100112",
            "telephone_number": "509-464-6208",
            "fax_number": "888-316-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 S REGAL ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992234704",
            "telephone_number": "509-464-6208",
            "fax_number": "888-316-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST SPINE AND PAIN MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-02",
        "last_updated": "2019-08-26",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-464-6208",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Spine and Pain Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.